I hereby submit my request for the following type of report:
Note: EMS Reports emailed to the requester are required to be encrypted with a password for privacy protection. You will be required to enter this password in order to open the emailed document.
Note: Written documentation supporting legal right to such protected class information is required in cases where the requester is neither the patient nor the legal guardian for the patient. Such documentation must be provided at the time the request is submitted.